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HomeMy WebLinkAboutBLD9692 Mobile Home - BLD Application - 12/10/1979 . Yatet, William G. #9b92 12-10-79 Beard's Cove #8, Lot 129 Mobile Home A BUILDING PEOWT APPLICATION •� �, MASON COUNTY P.O. Box 186 Shelton, Washington 98584 426-5593 I � G� DATE ISSUED./�-�--� �J 1 PERMIT N0. J Z OWNER NAME MAIL ADDRESS CITY&STATE ZIP PHONE S- DIRECTIO S Q,JI� (;tJ19 TO JOB S TE ' d - e CO V LEGAL / -1 G� �� I�/� - ()(SEE ATTACHED SHEET) DESCR. © D tune, f— �l F,g-I L . NAME MAIL ADDRESS CITY&STATE LICENSE NO. PHONE CONTRACTOR �GL Q ` Z S, d g1 0 104 USE OF T If BUILDING S �i /V fir (? Class of work: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE Describe work: 41,5e LfZ , J .J Z'p Es oN vl dux 0 Valuation of work: $ PLAN CHECK FEE PER IT FEE SPECIAL CONDITIONS: BEDROOMS DECKS CARPORT ❑ NOTICE BATHR09MS //-'I, TOTAL SQ. FT. GARAGE L_1 ATTACHED 1 SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING NO. OF STORIES BASEMENT Ll OR AIR CONDITIONING. TOTAL SO. FT/. d0 FIREPLACE DETACHED L] THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED CONTRACTOR AFFIDAVIT IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER I certify that I am a currently registered contractor in WORK IS COMMENCED. the State of Washington and I the aware of the FOR OFFICE USE ONLY ordinance requirements regulating the work for which the permit is issued and all work done will be in conformance therewith. PERMANENT SHORELINES L; SEASONAL 1 1 FLOODPLAIN Li Firm E.D. NO. S.E.P.A. ;1 By Special Approvals IN OUT YES APPROVED NO Lic. No. Date ZONING PLANNING DEPT. OWNERS AFFIDAVIT HEALTH DEPT. 3 PUBLIC WORKS I certify that I am exempt from the requirements of the FIRE MARSHAL contract or registration law RCW 18.27, and am aware of the Mason County ordinance requirements for BUILDING DEPT. which this permit is issued and that all work done will ROAD ACCESS be in conformance therewith. MOTOR VEHICLE PERMIT �j APPLICATION AC TED BY PLANS CHECK BY APPROVED FOR ISSUANCE Owne �" Date. 2 BY PLA HECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH PLOT PLAN ADDRESS l PERMIT NO. f o —t,bt LEGAL DESCRIPTION LOT 4k ax)Q BLK ADDITION a SITE AREA I Q h 6Q Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS _J h[> Sq.Ft. INSTRUCTIONS TO APPLICANT THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.) FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN- SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA- TION A"'D SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR- TION THEREOF. INDICATE NORTH IN CIRCLE GRAP� SQUARES ARE OR 1"=20' O 1 ry Y -- . NJ ZA � I Z r cl�] 1 1 �n I/We certify that the proposed construction will con s and uses shown above and that no changes wi t� i hout first obtaining approval. 0 y t � t �b • A u B u [�- �'/Y to S NAME 31 OF OWNER(3) OF SIT STRUCTUR S IPRINT) IGNATURE OF OWNE 1 OR AU THO ED REPRESENTATIVE DO NOT WRITE BELOW THIS LINE APPROVED DISTRICT AS NOTED DATE SHELTON PRINTIN3